The present disclosure relates to surgical access systems. More particularly, it relates to systems serving as both an access port and retractor to facilitate performance of surgical procedures through an incision (or other opening), for example procedures performed in the abdominal cavity.
Surgical procedures for pathologies located deep within the body are conventionally performed on either an open surgical basis or via a minimally invasive approach. Both techniques typically require general anesthesia. With open surgery, a relatively long incision is formed through the skin and then spread apart or retracted to afford the surgeon access to tissue, organs, and other anatomy beneath the skin. These open surgery procedures can be highly traumatic to the patient, and often have a lengthy and painful post-operative recovery. Moreover, the substantial incision required to perform the procedure invariably results in a major scar.
Minimally invasive techniques (e.g., minimally invasive laparoscopic surgery or MILS) overcome many of the above concerns whereby one (or more) relatively small incisions are made through the skin, and endoscopic surgical tools inserted through the incision(s). Because the procedure is performed deep beneath the skin, a camera or other visualization device must be employed, meaning that the surgeon has only an indirect and/or two-dimensional view of the surgical field. The surgical tools utilized with minimally invasive procedures are uniquely formatted for manipulation through a small, enclosed access port and are thus complex and expensive. From a patient recovery perspective, it is desirable that only a single incision be made, and is often referred to as a “single port” minimally invasive procedure. Existing single port technology includes single port access (SPA) surgery (also known as laparo endoscopic single-site surgery (LESS)), single incision laparoscopic surgery (SILS), one port umbilical surgery (OPUS), single port incisionless conventional equipment-utilizing surgery (SPICES), natural orifice transumbilical surgery (NOTUS), and embryonic natural orifice transumbilical surgery (E-NOTES). Each approach is a surgically advanced procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's navel. These surgical procedures generally require the patient to be under general anesthesia, intubated and insufflated under laparoscopic visualization. Further, retraction to obtain visualization is generally achieved using an alternate point of entry.
Bariatric surgeries (e.g., gastric banding, gastric bypass, etc.) and other procedures in the abdominal cavity are but one example of a surgical scenario in which an open and or a minimally invasive technique can be employed. With the open surgical approach, an incision on the order of 20 cm (or more) is necessary to obtain surgical access. The trauma associated with this incision and corresponding retraction is significant. Conversely, with the laparoscopic approach, carbon dioxide insufflation of the abdomen is required, and multiple (though small) incisions are made to deploy all of the required endoscopic instrumentation. The port device(s) through which the instruments are inserted must maintain an air tight seal over the corresponding incision to ensure viability of the insufflation. Moreover, the caregiver setting in which the procedure is performed must have all of the expensive endoscopic instruments on hand.
In light of the above, conventional surgical procedures require the use of general anesthesia. Open surgery is highly traumatic to the patient. Minimally invasive procedures require an expensive laparoscopy platform (costing caregiver institutions millions of dollars) and as a result, are oftentimes simply not available to many patients. Therefore, a need exists for a surgical access system that is relatively inexpensive yet minimizes patient trauma, and meets three primary needs of the surgical setting: access, retraction and visualization.